Tuesday, November 11, 2008

Veterans Day: Looking at Veterans' Needs

This election season, the moniker of “Support the Troops” warring with “Support the Troops: Bring Them Home” fell off the national scene. Instead, veterans of Iraq and Afghanistan are quietly getting shipped home. As reporting in the Washington Post after the election showed, troops don’t necessarily have a ton of time to ponder election returns. On seeing the election results, one soldier even quipped, “We're all going home! … What time does the plane leave?”

In other words, solving some of the problems we have is nowhere near that simple, especially as we address the needs of our largest war veteran population since Vietnam. Following is an examination of the upcoming battles in veterans’ issues.

The Montgomery G.I. Bill

This year Congress passed an expanded version of the Montgomery G.I. Bill this summer, initially proposed by Sen. Jim Webb, addresses some of the key problems that a highly mobilized military presented. The bill expanded benefits to those that served on or after September 11, 2001 and increased funding of the G.I. Bill to total up to the cost of in-state tuition at a public university (including some housing benefits).

But the problem here isn't with the legislation; it's with the execution. The changes to the G.I. Bill are supposed to go into effect on August 1, 2009. But the Veterans Administration may not be ready by then to handle the high volume of paperwork that they are expecting to receive. Another problem is that many veterans may already be finishing school (or nearly finished) by the time the benefits go into effect, and the benefits aren't retroactive.

But the VA system isn't perfect. With an increased population of war veterans and only marginal increases in the VA budgets until 2006, the VA hospitals often don't have enough doctors or appointment times, with waits of up to 18 months for some patients, to meet the demand of patients. An audit [pdf ] conducted last year by the VA's inspector general found that only three-fourths of patients had wait times of less than 30 days , far fewer than the 95 percent the VA had originally claimed. Additionally about 1.8 million veterans are "uninsured" because they don't live near enough to a VA facility for that treatment to be accessible.

Post-Traumatic Stress Disorder

Of the roughly 1.7 million soldiers serving in Iraq and Afghanistan, about 300,000 of them -- 1 in 5 -- are estimated to be suffering from some form of PTSD or severe depression, according to a RAND report released earlier this year. The costs for treating these veterans can cost upwards of $6.2 billion. As recently as this May, a PTSD program director in Texas urged her facility to cut back on the number of PTSD diagnoses so that

Since there's no one way to treat a person for PTSD, the problem of treating all of these veterans becomes a very difficult one. Some propose interviewing all soldiers upon their return from a war deployment to get a baseline and flag those who may be susceptible to PTSD. More recently, the Army is trying a program where soldiers are treated in the field almost immediately after a traumatic event. There needs to be more research into the best and most effective ways to treat soldiers and veterans with PTSD.

What is especially problematic is that women who are sexually assaulted while deployed in a war zone can get a "double wammy" of PTSD. The VA has opened a few treatment facilities exclusively for women that can allow them to address their PTSD in an environment they perceive to be more safe.